The nurse is caring for a client with a history of renal failure and a new myocardial infarction. The nurse who is reviewing laboratory findings would call the doctor to report which of the following results?

Correct Answer: C

Rationale: Correct Answer: C - Calcium level of 7.0 mg/dL Rationale: 1. In a client with renal failure and myocardial infarction, monitoring calcium levels is crucial due to potential electrolyte imbalances. 2. A calcium level of 7.0 mg/dL is abnormally low (normal range is 8.5-10.5 mg/dL), indicating hypocalcemia which can lead to cardiac arrhythmias. 3. Low calcium levels can worsen heart function and increase the risk of complications in a client with a recent myocardial infarction. 4. Calling the doctor to report this critical result is essential for prompt intervention to prevent adverse cardiac events. Summary of Other Choices: A: Potassium level of 5.0 mEq/L - Within normal range, not urgent in this scenario. B: Sodium level of 145 mEq/L - Within normal range, not a priority in this context. D: Digoxin/d

Correct Answer: A

Rationale: The correct answer is A: Jugular vein distention. In patients with left ventricular heart failure, increased pressure in the heart can lead to jugular vein distention due to backflow of blood. This is a common physical symptom seen in such patients. Incorrect choices: - B: Hepatomegaly is not a typical physical symptom of left ventricular heart failure. It may be seen in conditions like liver cirrhosis. - C: Dyspnea is a common symptom in heart failure but is not specific to left ventricular heart failure. - D: Crackles are indicative of fluid accumulation in the lungs, which is more common in right-sided heart failure rather than left ventricular heart failure.

Correct Answer: D

Rationale: The correct answer is D: T wave. The T wave is upright, rounded, and symmetrical, occurring after the QRS complex on an ECG. This wave represents ventricular repolarization. The P wave (Choice A) represents atrial depolarization, the QRS complex (Choice B) represents ventricular depolarization, and the ST segment (Choice C) represents the period between ventricular depolarization and repolarization. Therefore, the T wave is the only waveform that fits the description given in the question.

Correct Answer: A

Rationale: The correct answer is A: CVP (Central Venous Pressure). In right-sided heart failure, the right side of the heart fails to pump effectively, leading to increased pressure in the venous system. CVP reflects the pressure in the vena cava close to the right atrium, thus elevated in right-sided heart failure. B: Left-ventricular end-diastolic pressure is elevated in left-sided heart failure. C: PAWP (Pulmonary Artery Wedge Pressure) is elevated in left-sided heart failure. D: Cardiac output is typically decreased in heart failure, not elevated.

Correct Answer: D

Rationale: The correct answer is D because the patient is a white woman aged 72 with a high blood pressure of 172/100 and physically inactive. Advanced age, high blood pressure, and physical inactivity are significant risk factors for coronary artery disease (CAD). Age is a non-modifiable risk factor, and hypertension and lack of physical activity are modifiable but critical factors contributing to CAD. Choice A is incorrect because although the patient is African American, has obesity, and high blood pressure, the age is younger than the patient in choice D. Choice B is incorrect as smoking and stress are risk factors but not as significant as age, high blood pressure, and physical inactivity. Choice C is incorrect since although the patient has high cholesterol and elevated blood pressure, the age and other risk factors are less significant compared to the patient in choice D.